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    Retinal shortening: Ultrasonic evaluation of proliferative vitreoretinopathy. Takkar Brijesh,Temkar Shreyas,Gaur Nripen,Venkatesh Pradeep,Chawla Rohan,Kumar Atul Indian journal of ophthalmology PURPOSE:To evaluate the effect of extraretinal proliferative vitreoretinopathy (PVR) on retinal shortening in eyes with rhegmatogenous retinal detachment (RD) using ultrasound (USG) and objectively prove the presence of intraretinal PVR (iPVR). METHODS:This is a double-masked pilot prospective controlled case series. Patients with total RD planned for vitreoretinal surgery were included in the study. USG was used to determine retinal-to-choroidal length ratios (RCRs) in all the quadrants. Group 1 included 10 patients with preoperative PVR more than Grade B while Group 2 had 14 with PVR of Grades A or B. Severe retinal shortening was defined as RCR < 0.8. Primary outcome measures were severe retinal shortening and an early unexplained recurrence of RD within 15 days of surgery. RESULTS:Mean RCRs were significantly low in all the four quadrants of Group 1 upon comparison with Group 2. The mean RCR had a good negative correlation with number of quadrants of PVR (R = -0.66, P ≤ 0.001). Overall, severe quadrantic retinal shortening was detected in nine patients. In these 9 patients, 11 of the 36 retinal quadrants had severe retinal shortening in the absence of extraretinal PVR (ePVR). Six patients developed early unexplained RD, and all of these belonged to Group 1. Severe quadrantic retinal shortening had the highest odds ratio of developing early unexplained RD (odds ratio = 58, P = 0.01). CONCLUSION:Retinal shortening occurs both due to ePVR and iPVR, and iPVR occurs independently at least in some cases. Severe quadrantic retinal shortening indicates poor primary anatomical prognoses. 10.4103/ijo.IJO_481_17
    Multiple subretinal fluid blebs after successful retinal detachment surgery: incidence, risk factors, and presumed pathophysiology. Kim Yong-Kyu,Ahn Jeeyun,Woo Se Joon,Hwang Duck Jin,Park Kyu Hyung American journal of ophthalmology PURPOSE:To investigate the incidence and the clinical factors associated with the occurrence of multiple subretinal fluid (SRF) blebs after successful rhegmatogenous retinal detachment (RD) repair. DESIGN:Retrospective, observational case series. METHODS:We retrospectively investigated the medical records of 185 eyes of 184 patients who had undergone successful RD surgery, either vitrectomy or scleral buckling. Each patient had undergone spectral-domain optical coherence tomography (SDOCT) combined with infrared reflectance (IR) imaging every 3 months postoperatively. We carefully examined postoperative SDOCT and fundus IR images, in an effort to identify any SRF blebs present. RESULTS:Multiple (≥3) SRF blebs were observed in 40 of 185 cases (21.6%). SRF blebs were first detected 1.7 ± 1.8 months postoperatively. In 22 cases that could be fully followed up, SRF blebs were completely absorbed 13.1 ± 6.1 months postoperatively. Multiple logistic regression analysis showed that only young age (<30 years) was significantly associated with the occurrence of multiple SRF blebs (odds ratio, 5.1; 95% confidence interval, 1.5-17.6; P = .010). Serial measurements of SRF bleb size using SDOCT showed that SRF bleb height was greatest at postoperative 2.9 ± 0.9 months, while SRF bleb width tended to decrease gradually over time. The SRF blebs typically spared large retinal vessels. CONCLUSIONS:Multiple SRF blebs are commonly found after successful RD surgery, especially in young patients. The serial morphologic features evaluated in this study indicate that multiple SRF blebs may result from the active reattachment of retinal pigment epithelium and photoreceptors during the resolution of RD. 10.1016/j.ajo.2013.12.030
    Changes in postoperative refractive outcomes following combined phacoemulsification and pars plana vitrectomy for rhegmatogenous retinal detachment. Cho Kwan Hyuk,Park In Won,Kwon Soon Il American journal of ophthalmology PURPOSE:To evaluate changes in postoperative refractive outcomes following combined phacoemulsification and pars plana vitrectomy for rhegmatogenous retinal detachment (RRD) compared with other retinal diseases. DESIGN:Retrospective observational case-control study. METHODS:A total of 55 patients who had combined surgery between January 2007 and December 2012 were enrolled. The 25 patients who underwent combined surgery for RRD were included in the RRD group, and 30 patients who underwent combined surgery for other vitreoretinal pathology were included in the control group. Refractive axial length and intraocular pressure (IOP) measurements were performed, and the factors influencing the postoperative refractive outcomes were analyzed. RESULTS:The mean differences between the postoperative and predicted refractive outcomes in the RRD group and the control group were -0.43D±0.67 (P=.046) and -0.08D±0.53 (P=.767), respectively. The mean preoperative IOPs of the affected eye and the fellow eye in the RRD group were 11.44 mm Hg±3.15 and 13.16 mm Hg±2.73 (P=.045), but no differences were found in the affected eyes and fellow eyes of the control group. The differences were 14.20 mm Hg±2.95 and 14.17 mm Hg±3.50, respectively (P=.974). The mean postoperative IOPs in the affected eyes and the fellow eyes of the 2 groups were not significantly different. For all eyes, the refractive differences correlated with IOP changes in the RRD group. (r=.659, r2=.435, P<.001). CONCLUSIONS:The postoperative refractive outcomes in the RRD group shifted toward myopia by a mean of 0.35 diopters compared with the control group. Normalizing preoperative lowered IOP after combined surgery in RRD may be the key factor in understanding this myopic shift. 10.1016/j.ajo.2014.04.023
    Topographic changes of retinal layers after resolution of acute retinal detachment. Kim Jae Hui,Park Do Young,Ha Hyo Shin,Kang Se Woong Investigative ophthalmology & visual science PURPOSE:To investigate changes in thickness profiles of retinal layers after resolution of recent onset rhegmatogenous retinal detachment METHODS:Spectral domain optical coherence tomography (SD-OCT) scans were performed for 28 patients diagnosed with unilateral inferior half or superior half retinal detachment who underwent retinal reattachment surgery. The thickness of each retinal layer was measured at 3000 μm and 2800 μm in the superior and inferior directions from the foveal center. The thicknesses of each retinal layer of the reattached retina were compared with those of the undetached region of the retina of the same eye. RESULTS:Sixteen patients were diagnosed with superior half and 12 patients were diagnosed with inferior half retinal detachment. The mean duration of retinal detachment was 6.9 ± 3.9 days. SD-OCT scans were performed 10.4 ± 6.9 months after the surgery. The thicknesses of the outer nuclear layer and photoreceptor layer in the reattached retina were significantly thinner than those of the undetached retina (P = 0.012, and P = 0.018, respectively). CONCLUSIONS:Our findings suggest that prominent retinal structural sequelae, especially in outer nuclear layer and photoreceptor layer, can be induced by a short duration of retinal detachment. Our findings also underscore the important role of initial retinal injuries that occur within the first several days on the long term structural prognosis. (ClinicalTrials.gov number, NCT01587794). 10.1167/iovs.12-10155
    CHOROIDAL THICKNESS CHANGES AFTER VITRECTOMY WITH SILICONE OIL TAMPONADE FOR PROLIFERATIVE VITREORETINOPATHY RETINAL DETACHMENT. Odrobina Dominik,Gołębiewska Joanna,Maroszyńska Iwona Retina (Philadelphia, Pa.) PURPOSE:To access the potential effect of vitrectomy and silicone oil tamponade on the choroid. METHODS:Eighteen patients (18 eyes) who had undergone pars plana vitrectomy with 1,000-cSt silicone oil tamponade for proliferative vitreoretinopathy retinal detachment were included in this retrospective study. All patients underwent ophthalmologic examinations before treatment and 1 week and 1, 3, and 6 months after vitrectomy with silicone oil tamponade. Choroidal thickness was measured using enhanced depth imaging optical coherence tomography (Spectralis; Heidelberg Engineering) in a horizontal and vertical section beneath the fovea. RESULTS:Choroidal thickness statistically significantly decreased till 3 months after pars plana vitrectomy with silicone oil tamponade: under the center of the fovea (P = 0.014) and in the temporal (P = 0.029), superior (P = 0.046), and inferior areas, determined at 1,500 μm from the center of the fovea (P = 0.030). After 6 months, the desired effect in the form of a decrease in the choroidal thickness was even more prominent, both under the center of the fovea (P < 0.001) and in the nasal (P < 0.001), temporal (P < 0.001), superior (P < 0.001), and inferior areas at 1,500 μm from the center of the fovea (P < 0.001). CONCLUSION:Choroidal thickness is reduced in eyes receiving silicone oil intraocular tamponade. Silicone oil tamponade may have an impact on the structure and proper functioning of the choroid. The measurements of the choroidal thickness by optical coherence tomography might be a very good tool to detect early changes in choroidal thickness and impact the decision when to remove silicone oil. 10.1097/IAE.0000000000001437
    VITREORETINAL SURGERY WITH SILICONE OIL TAMPONADE IN PRIMARY UNCOMPLICATED RHEGMATOGENOUS RETINAL DETACHMENT: Clinical Outcomes and Complications. Antoun Joelle,Azar Georges,Jabbour Elyse,Kourie Hampig Raphael,Slim Elise,Schakal Alexandre,Jalkh Alex Retina (Philadelphia, Pa.) BACKGROUND:To determine the anatomical and functional outcomes and possible complications after pars plana vitrectomy (PPV) with silicone oil (SO) tamponade in primary uncomplicated rhegmatogenous retinal detachments. METHODS:This is a prospective observational study. Overall, 62 consecutive patients who underwent surgical repair by PPV and SO injection for primary uncomplicated rhegmatogenous retinal detachment between January 01, 2006 and April 30, 2012 were followed. In general, PPV was chosen over scleral buckling when a significant cataract or a vitreous hemorrhage prevented adequate fundus visualization. Silicone oil was chosen over gas tamponade in patients living at 1,000 meters above the sea level, where SF6 or C3F8 tamponade could not be performed because of the risk of acute increase of intraocular pressure (IOP). One thousand centistokes SO was used in all eyes. At all visits, patients had a detailed ocular history and thorough bilateral evaluation, including best-corrected visual acuity, anterior segment examination, and IOP measurements by aplanation and fundus examination. Outcomes were assessed at 1 day, 1 week, 1 month, 3 months, 6 months, and every 6 months thereafter. Increased IOP was defined as an IOP of more than 21 mmHg. RESULTS:Anatomical success rate, final best-corrected visual acuity, IOP elevation, cataract formation, and other complications were the main outcome measures. This study included 62 eyes of 62 patients (41 men and 21 women) that underwent retinal detachment repair by PPV and SO injection. The age at the time of intervention was 57.6 ± 10.5 years (mean ± standard deviation; range, 34-79 years). All patients were whites. Mean follow-up was 24.5 ± 17.3 months (range, 6-70 months). Anatomical success rate defined as retinal reattachment 6 months after SO removal was 93.5%. Final BCVA was improved in 55 eyes (88.7%), with a mean of 4 Snellen lines, unchanged in 5 (8.1%), and worse in 2 eyes (3.2%), with a mean of 3 Snellen lines. Mean duration of SO tamponade was 5.12 ± 2.37 months (range, 2-12 months). From the 30 eyes that were still phakic after vitrectomy, 24 eyes (80.0%) underwent cataract surgery within a period of 7.37 ± 3.00 months (range, 2-13 months). Thirty-five eyes (56.5%) had an increase in IOP during the follow-up period. Thirty-one patients had transient ocular hypertension requiring topical treatment during the immediate postoperative period (one month). Only 1 eye (2.9%) required filtrating drainage surgery for IOP control. No eyes developed optic neuropathy secondary to IOP elevation. CONCLUSION:Pars plana vitrectomy with SO injection seems to be a safe and efficient surgical approach in the treatment of primary uncomplicated rhegmatogenous retinal detachment in patients living in high altitude (>1,000 m). Also, PPV and SO injection are associated with good anatomical and functional outcomes in our series. Reattachment rates are high, and rates of proliferative vitreoretinopathy are low. Cataract formation and elevated IOP represent frequent but successfully controlled complications. 10.1097/IAE.0000000000001008
    WIDEFIELD SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY IMAGING OF PERIPHERAL ROUND RETINAL HOLES WITH OR WITHOUT RETINAL DETACHMENT. Casswell Edward J,Abou Ltaif Sleiman,Carr Thomas,Keane Pearse A,Charteris David G,Wickham Louisa Retina (Philadelphia, Pa.) PURPOSE:To describe the widefield spectral-domain optical coherence tomography features of peripheral round retinal holes, with or without associated retinal detachment (RD). METHODS:Retrospective, observational study of 28 eyes with peripheral round retinal holes, with and without RD. Patients underwent imaging with a widefield 50-degree spectral-domain optical coherence tomography (Heidelberg Engineering, Germany) and Optos ultra-widefield imaging systems (Optos, United Kingdom). RESULTS:Vitreous attachment at the site of the retinal hole was detected in 27/28 (96.4%) cases. Cases were split into three groups: RHs with RD (n = 12); RHs with subretinal fluid (n = 5), and flat RHs (n = 11), with minimal or no subretinal fluid. 91.6% retinal holes associated with subretinal fluid or RD had vitreous attachment at the site of the hole. Eighty percent had vitreous attachment at both edges of the retinal hole, in a U-shape configuration, which appeared to exert traction. By contrast, flat retinal holes had visible vitreous attachment only at one edge of the retinal hole in 45.4%. CONCLUSION:Vitreous attachment was commonly seen at the site of round retinal holes. Vitreous attachment at both edges of the retinal hole in a U-shape configuration was more commonly seen at holes associated with subretinal fluid or RD. 10.1097/IAE.0000000000002133
    WIDE-FIELD INFRARED IMAGING: A Descriptive Review of Characteristics of Retinoschisis, Retinal Detachment, and Schisis Detachments. Ho Vincent Y,Wehmeier Jarrod M,Shah Gaurav K Retina (Philadelphia, Pa.) PURPOSE:Retinoschisis and retinal detachments are primarily differentiated based on characteristic examination findings. In diagnostically challenging cases, noncontact wide-field infrared imaging can help diagnosis and visualize the extent/margins of retinoschisis, retinal detachment, or combined schisis detachments by comparing reflectivity patterns. METHODS:This is a retrospective, observational, descriptive case series of 14 eyes of 14 nonconsecutive patients, ranging from 28 to 89 years old (mean 61), diagnosed with retinoschisis, retinal detachment, or schisis detachment from May 5, 2014 to March 4, 2015. Patients with secondary retinoschisis and/or retinal detachment from other causes were not included in the study. Heidelberg Wide-Field Module lens and Heidelberg Spectralis HRA+OCT machine (Heidelberg Engineering, Heidelberg, Germany) were used to obtain noncontact, wide-field infrared images on each study eye. RESULTS:Seven eyes with retinal detachments, four with retinoschises, and three with schisis detachments were imaged using this novel wide-field infrared technique. Retinoschisis appears light and translucent with prominent vasculature, retinal detachments appear dark and opaque, and combined retinoschisis/retinal detachment exhibit mixed reflectivity patterns. CONCLUSION:Wide-field infrared imaging provides a quick, noncontact, noninvasive method to accurately diagnose and to monitor for progression of retinoschisis, retinal detachment, or combined schisis detachments. 10.1097/IAE.0000000000000963
    Retinal detachment after open globe injury. Stryjewski Tomasz P,Andreoli Christopher M,Eliott Dean Ophthalmology PURPOSE:To characterize the development of retinal detachment (RD) after open globe trauma. DESIGN:Case-control study. PARTICIPANTS:A total of 892 patients comprising 893 open globe injuries (OGIs), of whom 255 were ultimately diagnosed with RD, with the remaining eyes serving as controls. METHODS:Retrospective chart review of patients with OGIs presenting to the Massachusetts Eye and Ear Infirmary between 1999 and 2011. Kaplan-Meier analysis was used to estimate the time to detachment, and multivariable logistic regression was used to define the clinical factors associated with RD after OGI. MAIN OUTCOME MEASURES:Demographic and clinical characteristics at the time of presentation after OGI, date of RD diagnosis, and last date of follow-up. RESULTS:Primary repair of the open globe was typically undertaken within hours of presentation. A total of 255 eyes were ultimately diagnosed with RD after open globe trauma, yielding an incidence of 29% (95% confidence interval, 26-32). For eyes that developed RD, 27% (69/255) detached within 24 hours of primary open globe repair, 47% (119/255) detached within 1 week, and 72% (183/255) detached within 1 month. Multivariable regression analysis revealed the presence of vitreous hemorrhage (odds ratio [OR], 7.29; P < 0.001), higher zone of injury (OR, 2.51 per integer increase in zone number; OR, 1.00-6.30; P < 0.001), and poorer logarithm of the minimum angle of resolution (logMAR) visual acuity at the time of presentation after OGI (OR, 2.41 per integer increase in logMAR visual acuity; OR, 1.00-81.30; P < 0.001) to be associated with RD. A screening tool was created: the Retinal Detachment after Open Globe Injury score. CONCLUSIONS:Retinal detachment is common after open globe trauma, although often not appearing until days to weeks after the initial traumatic event. Several clinical variables at the time of initial presentation can predict the future risk of detachment. 10.1016/j.ophtha.2013.06.045
    Biomarkers for PVR in rhegmatogenous retinal detachment. Zandi Souska,Pfister Isabel B,Traine Peter G,Tappeiner Christoph,Despont Alain,Rieben Robert,Skowronska Magdalena,Garweg Justus G PloS one PURPOSE:Various profibrotic and proinflammatory cytokines have been found upregulated in uncomplicated primary retinal detachment (pRD), but without providing a uniform picture. Here, we compare the cyto- and chemokine profiles in pRD with and without proliferative vitreoretinopathy (PVR) in an attempt to unravel relevant differences not in single cytokines, but in the cytokine profiles at diagnosis. METHODS:Undiluted vitreous fluid (VF) was obtained at the beginning of surgery from 174 eyes with pRD without relevant PVR (maximally grade B; group 1; n = 81) and with moderate or advanced PVR requiring a gas tamponade (group 2; n = 49) or silicon oil filling (group 3; n = 44). VF of eyes undergoing macular hole (MH) surgery served as controls (group 4; n = 26). Forty-three cytokines were quantified in parallel using a multiplex cytokine analysis system (Bioplex). For all comparisons we applied Holm's correction to control for multiple comparisons. RESULTS:44.9% of group 2 eyes presented grade C1 and 55.1% C2-C3, whereas 86.4% of group 3 eyes exhibited a PVR grade of C2-D. CCL19 was the only cytokine that displayed higher concentrations in the vitreous of eyes with PVR C1 compared to lower PVR grades. Eyes with PVR C2-D showed higher levels of CCL27, CXCL6, IL4, IL16, CXCL10, CCL8, CCL22, MIG/CXCL9, CCL15, CCL19, CCL 23 and CXCL12 compared to controls. Interestingly, no difference of cytokine levels was detected between C1 and C2-D PVR. CONCLUSIONS:CCL19 may represent a potential biomarker for early PVR progression that holds promise for future diagnostic and therapeutic applications. 10.1371/journal.pone.0214674
    CONCENTRATIONS OF VITREAL CYTOKINES IN RHEGMATOGENOUS RETINAL DETACHMENT. Danielescu C,Zugun-Eloae F,Zlei Mihaela Revista medico-chirurgicala a Societatii de Medici si Naturalisti din Iasi UNLABELLED:Proliferative vitreoretinopathy (PVR) is one of the most frequent causes of failure of rhegmatogenous retinal detachment (RRD) surgery. AIM:To measure the vitreous levels of granulocyte colony stimulating factor (G-CSF) and monocyte chemoattractant protein 1 (MCP-1) in eyes with RRD and in a control group. MATERIAL AND METHODS:A prospective study of 40 patients operated for RRD (study group) and 20 patients with epiretinal membrane or macular holes (selected as control group since they needed vitrectomy but had attached retinas). Vitreous samples were collected during vitrectomy and were assessed for the presence of cytokines using a fluorescent bead-based multiplex assay. RESULTS:The concentration of G-CSF (8.59 pg/ml) and MCP-1 (1615.2 pg/ml) were significantly increased in the study group, when compared to the control group (0 and 469.13 pg/ml, respectively). MCP-1 was also significantly increased in the subgroup of patients with PVR compared to the patients with uncomplicated RRD. CONCLUSIONS:The levels of these biomarkers support the idea that proliferative vitreoretinopathy has an inflammatory component.
    Preoperative aqueous humour flare values do not predict proliferative vitreoretinopathy in patients with rhegmatogenous retinal detachment. Mulder Verena C,Tode Jan,van Dijk Elon Hc,Purtskhvanidze Konstantine,Roider Johann,van Meurs Jan C,Treumer Felix The British journal of ophthalmology BACKGROUND/AIMS:Patients with rhegmatogenous retinal detachment (RRD) who develop postoperative proliferative vitreoretinopathy (PVR) have been found to have higher preoperative laser flare values than patients with RRD who do not develop this complication. Measurement of laser flare has therefore been proposed as an objective, rapid and non-invasive method for identifying high-risk patients. The purpose of our study was to validate the use of preoperative flare values as a predictor of PVR risk in two additional patient cohorts, and to confirm the sensitivity and specificity of this method for identifying high-risk patients. METHODS:We combined data from two independent prospective studies: centre 1 (120 patients) and centre 2 (194 patients). Preoperative aqueous humour flare was measured with a Kowa FM-500 Laser Flare Meter. PVR was defined as redetachment due to the formation of traction membranes that required reoperation within 6 months of initial surgery. Logistic regression and receiver operating characteristic analysis determined whether higher preoperative flare values were associated with an increased risk of postoperative PVR. RESULTS:PVR redetachment developed in 21/314 patients (6.7%). Median flare values differed significantly between centres, therefore analyses were done separately. Logistic regression showed a small but statistically significant increase in odds with increasing flare only for centre 2 (OR 1.014; p=0.005). Areas under the receiver operating characteristic showed low sensitivity and specificity: centre 1, 0.634 (95% CI 0.440 to 0.829) and centre 2, 0.731 (95% CI 0.598 to 0.865). CONCLUSIONS:Preoperative laser flare measurements are inaccurate in discriminating between those patients with RRD at high and low risk of developing PVR. 10.1136/bjophthalmol-2016-309134
    Amino acid and vascular endothelial growth factor levels in subretinal fluid in rhegmatogenous retinal detachment. Yalcinbayir Ozgur,Buyukuysal Rifat Levent,Gelisken Oner,Buyukuysal Cagatay,Can Basak Molecular vision PURPOSE:To study the concentrations of amino acids and vascular endothelial growth factor (VEGF) in subretinal fluid (SRF) of cases with rhegmatogenous retinal detachment (RRD). The relevance of the results with postoperative anatomic and functional success in RRD was investigated. METHODS:Fifty-three patients were included in this prospective study. The study group consisted of 46 patients who had scleral buckling surgery with the diagnosis of RRD, and SRF was obtained during the surgery. The control specimens consisted of vitreous samples of seven patients who were diagnosed with pars plana vitrectomy without RRD. Study cases were divided into three groups, corresponding to the duration of retinal detachment. Clinical characteristics, including best corrected visual acuity (BCVA) and anatomic status at month 6, were recorded. Concentrations of 15 selected amino acids were quantified by using high performance liquid chromatography, and VEGF levels were measured with enzyme immunoassay. RESULTS:When compared with the control group, SRF concentrations of aspartate, citrulline, glutamate, and glycine increased significantly in the study group (p<0.05). Statistical analysis showed that concentrations of alanine, isoleucine, leucine, methionine, phenylalanine, threonine, tyrosine, and valine decreased (p<0.05). SRF levels of glutamine, taurine, and serine had no significant change. SRF VEGF levels were significantly higher than the vitreous samples of the controls (p<0.001). Time-dependent changes and interactions between VEGF and amino acids were observed. There was no correlation between the concentrations of amino acids or VEGF with the parameters of BCVA and anatomical success. CONCLUSIONS:Significant changes occur in concentrations of amino acids and VEGF in SRF of cases with RRD. Our results suggest that several mechanisms contribute to the pathophysiology.
    Incidence and Surgical Management of Simultaneous Bilateral Retinal Detachment. Finger M L,Bovey E,Wolfensberger T J Klinische Monatsblatter fur Augenheilkunde BACKGROUND:Simultaneous bilateral retinal detachment (RD) is very rare and its incidence has not been very well characterised. MATERIAL AND METHODS:Retrospective review of RD cases treated at the Jules Gonin Eye Hospital between 1999 and 2010. RESULTS:Over the 11 year period, 10 patients (20 eyes) with simultaneous bilateral RD were identified (average incidence among RD= 0.9 %). Mean age: 46.4 ± 17.6 years, with a M : F Ratio of 6 : 4. Pseudophakia was present in 10 eyes and myopia ≥-5.0 dioptres in 11 eyes. Visual symptoms were unilateral in 7 patients, bilateral in 2 patients and absent in one patient. RD was macula-on in 15 eyes and macula-off in 5 eyes. Atrophic holes were present in 11 eyes, U-tears in 6 eyes and a combination in 3 eyes. Primary surgery consisted of buckle surgery (11 eyes), vitrectomy (6 eyes) and combines technique (3 eyes). The final anatomical success rate was 100 %. Mean follow-up time was 22.7 ± 4.95 months. CONCLUSION:The incidence of bilateral simultaneous RD appears to be very low and surgical success rates are excellent. Bilateral pre-operative dilated fundoscopy is mandatory, as the majority of patients have unilateral symptoms. 10.1055/s-0041-111827
    Tractional Retinal Detachment Secondary to Diabetic Retinopathy. Li Daniel Q,Choudhry Netan JAMA ophthalmology 10.1001/jamaophthalmol.2018.3507
    CLINICAL FEATURES OF AFFECTED AND UNDETACHED FELLOW EYES IN PATIENTS WITH FEVR-ASSOCIATED RHEGMATOGENOUS RETINAL DETACHMENT. Yuan Miner,Ding Xiaoyan,Yang Yu,Liu Fang,Li Jiaqing,Liang Xiaoling,Zhang Xiongze,Hu Andina,Li Zijing,Zhan Zongyi,Lu Lin Retina (Philadelphia, Pa.) PURPOSE:To report the clinical characteristics of the affected and fellow eyes in patients with familial exudative vitreoretinopathy-associated rhegmatogenous retinal detachment (FEVR-RRD). METHODS:This was a retrospective observational case series. The affected and fellow eyes were given complete examinations. The age, sex, clinical features of the affected eyes, and varied abnormalities of the fellow eyes were analyzed. RESULTS:Forty-three patients with FEVR-RRD were included. The average age was 21.8 ± 10.9 years, and the males (19.9 ± 9.6) were younger than the females (28.1 ± 1.2). Retinal round holes were noted in 32 (71.1%) eyes. In addition, horseshoe retinal tears and giant retinal tears were present in 10 (22.2%) eyes and 3 (6.7%) eyes. Subretinal fibrosis was seen in 20 (44.4%) eyes, and choroidal detachment was shown in 6 (13.3%) of the eyes. A high prevalence of abnormalities was noted in the undetached fellow eyes in the peripheral retina, including vascular leakage in fundus fluorescein angiography (75.6%), lattice degeneration (53.7%), and vitreous traction (51.2%). CONCLUSION:Male patients with FEVR-RRD experience an earlier onset than females in our series. Retinal tears, even giant tears, could be responsible for FEVR-RRD. The fellow eyes of FEVR-RRD patients were characterized by predetachment changes, which need both lifelong monitoring and timely vision-saving intervention. 10.1097/IAE.0000000000001171
    Retinal detachment in severe myopia. Moisseiev Elad,Yiu Glenn Lancet (London, England) 10.1016/S0140-6736(16)31407-6
    A comparison of strict face-down positioning with adjustable positioning after pars plana vitrectomy and gas tamponade for rhegmatogenous retinal detachment. Chen Xiao,Yan Ying,Hong Ling,Zhu Li Retina (Philadelphia, Pa.) PURPOSE:To compare face-down positioning and adjustable positioning after pars plana vitrectomy for the repair of rhegmatogenous retinal detachment. METHODS:Sixty-eight eyes from 68 patients with rhegmatogenous retinal detachment were included in this study. All patients received pars plana vitrectomy with long-acting gas for tamponade and then subdivided into 2 groups: 29 were included in a face-down group and 39 were included in the adjustable positioning group. Patients were followed up for 3 months. The main outcome was the rate of anatomical retinal reattachment. Secondary outcome measures were best-corrected visual acuity and postoperative complications. RESULTS:Most of the preoperative baseline characteristics between the two groups were not significantly different. The anatomical success rates after primary surgery were 89.7% and 92.3% for the face-down group and the adjustable positioning group, respectively (P = 1.00). Best-corrected visual acuity at the 3-month postoperative visit was 0.74 ± 0.25 for the face-down group and 0.77 ± 0.36 for the adjustable positioning group, respectively (P = 0.41). The rates of complications were not statistically different in the two groups. CONCLUSION:Adjustable positioning after pars plana vitrectomy and gas tamponade for rhegmatogenous retinal detachment repair is effective and safe. Face-down positioning seems not to be necessary for all patients with rhegmatogenous retinal detachment. 10.1097/IAE.0000000000000413
    Optical coherence tomography evaluation of patients with macula-off retinal detachment after different postoperative posturing: a randomized pilot study. Peiretti Enrico,Nasini Francesco,Buschini Elisa,Caminiti Giulia,Lesnik Oberstein Sarit Y,Willig Alissa,Bijl Heico M,Mura Marco Acta ophthalmologica PURPOSE:To assess the presence of outer and inner retinal folds (RFs) and drop-out of the ellipsoid zone (EZ) occurring after surgical repair of macula-off rhegmatogenous retinal detachment (RRD) with different postoperative posture and preoperative use of adjuvant perfluorocarbon liquid (PFCO). METHODS:In this prospective study, 56 eyes of 56 consecutive patients affected by RRD were subjected to 23- or 25-gauge pars plana vitrectomy (PPV). The patients were randomized in four groups (14 prone 5 hr without PFCO, 14 supine 5 hr without PFCO, 14 prone 5 hr with PFCO and 14 supine 5 hr with PFCO) and followed up with spectral domain optical coherence tomography (SD-OCT). RESULTS:Spectral domain optical coherence tomography (SD-OCT) was recorded before surgery, at days 30 and 90 to detect the presence of outer RFs, inner RFs and drop-out of EZ and to follow their variation over time. No statistical significance was found in our groups for outer RFs, inner RFs, drop-out of EZ formation and evolution. The postoperative best-corrected visual acuity (BCVA) improved in all groups (mean preoperative BCVA 1.47 logMar ± 0.19, mean postoperative BCVA 0.27 logMar ± 0.11, p < 0.01), without statistical variations between the four groups in BCVA after surgery. CONCLUSION:The use of adjuvant and variation in postoperative position did not change the risk of presenting outer RFs, inner RFs and drop-out of EZ after RRD. 10.1111/aos.13397
    Impact of postoperative positioning on the outcome of pars plana vitrectomy with gas tamponade for primary rhegmatogenous retinal detachment: comparison between supine and prone positioning. Otsuka Keiko,Imai Hisanori,Miki Akiko,Nakamura Makoto Acta ophthalmologica PURPOSE:To compare the postoperative anatomic success rates and the frequency of complications between prone or supine postoperative positioning after transconjunctival sutureless vitrectomy (TSV) for rhegmatogenous retinal detachment (RRD). METHODS:All patients underwent primary 27-gauge TSV for the treatment of primary RRD. Patients were divided into two groups as follows: group A was patients instructed to keep strict postoperative prone positioning for a minimum of 8 days. Group B was patients instructed to keep the prone positioning on the day of the surgery followed by supine positioning for minimum of 7 days from the day after surgery. RESULT:Sixty-two eyes were enrolled (group A: 32, group B: 30). There was no significant difference in baseline data between two groups. The initial and final anatomical success rates were 93.8% and 100% in group A and 93.3% and 100% in group B, respectively (p = 1, p = 1, respectively). Posterior synechia of the iris occurred in one eye in group A and in two eyes in group B (p = 0.61). Macular pucker and retinal fold did not occur in either group. Preoperative intraocular pressure (IOP; mmHg) was 14.5 ± 2.9 in group A and 14.5 ± 2.6 in group B (p = 0.92). Intraocular pressure (IOP) was not statistically different between the groups during the follow-up period (p = 0.36, p = 0.07, respectively). CONCLUSION:Supine positioning may be an option as a postoperative positioning after TSV and gas tamponade for the treatment of RRD. 10.1111/aos.13482
    INTERNAL LIMITING MEMBRANE PEELING DURING PARS PLANA VITRECTOMY FOR RHEGMATOGENOUS RETINAL DETACHMENT: Cost Analysis, Review of the Literature, and Meta-analysis. Yannuzzi Nicolas A,Callaway Natalia F,Sridhar Jayanth,Smiddy William E Retina (Philadelphia, Pa.) PURPOSE:To evaluate the visual and potential economic impact of primary internal limiting membrane (ILM) peeling in primary treatment of rhegmatogenous retinal detachment. METHODS:A PubMed search was performed to extract data regarding the rate of epiretinal membrane formation and the rate of secondary pars plana vitrectomy with membrane peel after repair of rhegmatogenous retinal detachment with or without ILM peeling. Data were aggregated and analyzed in a meta-analysis. This information was used to perform a cost analysis to determine the economic ramifications of primary ILM peeling. RESULTS:Six included studies compared the outcomes of eyes receiving pars plana vitrectomy for rhegmatogenous retinal detachment repair with and without primary ILM peel. The cumulative rate of epiretinal membrane formation was 29% (86/295) in the eyes without ILM peel and 3% (8/289) in the eyes with ILM peel. The cumulative rate of secondary pars plana vitrectomy/membrane peel was 16% (22/141) in the eyes without ILM peel and 0% (0/158) in the eyes with ILM peel. The weighted summary point estimate odds ratio was 0.083 (95% confidence interval 0.042-0.164), indicating a statistically significant protective effect across the 6 studies of ILM peeling and the development of epiretinal membrane. Based on published data, the average dollars saved by conducting a primary ILM peel was $615 in a facility setting and $364 in an ambulatory surgical center. CONCLUSION:Published, mainly retrospective, data suggest that primary ILM peel in rhegmatogenous retinal detachment repair may have a significant reduction in the rate of postoperative epiretinal membrane and may lessen the need for secondary pars plana vitrectomy/membrane peel. Furthermore, from an economic perspective, the reduction in the need for secondary surgery may justify the higher cost with primary ILM peel. 10.1097/IAE.0000000000002248
    Validity of aqueous flare measurement in predicting proliferative vitreoretinopathy in patients with rhegmatogenous retinal detachment. Conart Jean-Baptiste,Kurun Soydan,Ameloot François,Tréchot Fanny,Leroy Bertrand,Berrod Jean-Paul Acta ophthalmologica PURPOSE:To investigate aqueous flare as a preoperative predictor for later proliferative vitreoretinopathy (PVR) development in patients with rhegmatogenous retinal detachment (RD) and to determine the validity of this measurement in patients at low clinical risk for postoperative PVR. METHODS:This study included 100 eyes of 100 patients who underwent surgery for primary RD. Aqueous flare was determined preoperatively with a laser flare-cell meter (Kowa FM-500, Kowa Company Ltd, Tokyo, Japan). Patients were followed for at least 6 months postoperatively. Failures related to PVR were recorded for statistical analysis. RESULTS:Twenty eyes (20%) developed PVR postoperatively. Preoperative flare values in these eyes were significantly higher than in eyes with no redetachment (48.12 ± 61.24 versus 17.74 ± 29.63 photon counts per millisecond (pc/ms), p = 0.002). The odds ratio for PVR development with flare values >15 pc/ms was 12.3 (p < 0.0001, 95% confidence interval, 3.54-42.59). Of 54 eyes at low clinical risk for postoperative PVR, five developed PVR postoperatively. Flare values were significantly higher in these eyes (25.30 ± 7.10 pc/ms) than in eyes with no redetachment (12.44 ± 10.16 pc/ms, p = 0.008). Using logistic regression, the odds ratio of PVR redetachment risk increased by the factor 1.078 per 1 pc/ms of flare value (95% CI, 1.01-1.15). CONCLUSION:Preoperative aqueous flare is a strong predictive factor for PVR redetachment. The laser flare-cell meter provides a fast and safe tool to accurately identify patients at risk for postoperative PVR, especially when clinical examination did not predict this risk. 10.1111/aos.13254
    Visual recovery after retinal detachment with macula-off: is surgery within the first 72 h better than after? Frings Andreas,Markau Nastassija,Katz Toam,Stemplewitz Birthe,Skevas Christos,Druchkiv Vasyl,Wagenfeld Lars The British journal of ophthalmology AIMS:To investigate the influence of lag time between the onset of central visual acuity loss and surgical intervention of macula-off retinal detachment. METHODS:This retrospective case series examined all consecutively treated eyes with primary macula-off retinal detachment at the University Hospital Hamburg (Germany) from February 2010 to February 2015. Records of 1727 patients operated by six surgeons were reviewed. Eighty-nine eyes (5.2%) from 89 patients met the inclusion and exclusion criteria. The main outcome measure studied was final visual acuity as a function of symptom duration of macula-off detachment. Secondary outcome measures studied were influence of age and surgical technique. Symptom duration was defined as the time from the onset of loss of central vision to surgical intervention. RESULTS:After 10 days no clinically relevant difference was seen in final visual acuity. Eyes with symptom duration of 3 days or less achieved best final visual acuity (p<0.001). Age and preoperative visual acuity had no influence while vitrectomised eyes had better outcome compared with those with scleral buckling. CONCLUSIONS:Our study suggests that 1. After 10 days of central visual acuity loss, the final visual outcome is clinically comparable and independent of further delay of surgery up to 30 days. 2. Eyes treated up to 3 days after onset of loss of central vision have better final visual acuity than eyes with longer lag time. However, we did not find statistically significant differences within the first 3 days. 3. Surgery for macula-off retinal detachment may therefore most likely be postponed without compromising the patient's visual prognosis. 10.1136/bjophthalmol-2015-308153
    Impact of Metamorphopsia on Quality of Life after Successful Retinal Detachment Surgery. Saleh Maher,Gauthier Anne-Sophie,Delbosc Bernard,Castelbou Marie Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde PURPOSE:To determine the impact of metamorphopsia on quality of life after successful retinal detachment (RD) surgery and to determine which retinal changes are related to the most severe distortions. DESIGN:This was a prospective, observational, consecutive study. METHODS:The study included 58 eyes of 58 consecutive patients who underwent successful RD surgery. At 6 months postoperatively, the incidence and severity of metamorphopsia were assessed by a quality-of-life questionnaire. Microstructure retinal changes were studied with spectral domain optical coherence tomography (OCT). The questionnaire score was compared with pre- and postoperative OCT findings. RESULTS:Overall, 20 patients (34.5%) had metamorphopsia. Outer retinal folds (ORFs) and the macular status before surgery, together with postoperative ORFs and decrease in ellipsoid and/or interdigitation photoreceptor zone reflectivity, were identified as risk factors of developing metamorphopsia (relative risk, 1.7-4.8). The most severe visual distortions were associated with ORFs. CONCLUSION:Metamorphopsia is a frequent occurrence after RD surgery and its impact on patients' quality of life appears to be limited. While it may be difficult to prevent photoreceptor loss occurring after surgery, limiting postoperative ORFs may be helpful in reducing their incidence. 10.1159/000486164
    SMOKING IS A RISK FACTOR FOR PROLIFERATIVE VITREORETINOPATHY AFTER TRAUMATIC RETINAL DETACHMENT. Eliott Dean,Stryjewski Tomasz P,Andreoli Michael T,Andreoli Christopher M Retina (Philadelphia, Pa.) PURPOSE:To determine the incidence of retinal redetachment due to proliferative vitreoretinopathy after open-globe trauma in smokers and nonsmokers. METHODS:A total of 892 patients comprising 893 open-globe injuries, in whom 255 eyes were diagnosed with a retinal detachment, and 138 underwent surgical repair were analyzed in a retrospective case-control study. Time to redetachment was examined using the Kaplan-Meier method and analysis of risk factors was analyzed using Cox proportional hazards modeling. RESULTS:Within one year after retinal detachment surgery, 47% (95% CI, 39-56%) of all 138 repaired retinas redetached because of proliferative vitreoretinopathy. Being a smoker was associated with a higher rate of detachment (adjusted hazard ratio 1.96, P = 0.01). As shown in previous studies, the presence of proliferative vitreoretinopathy at the time of surgery was also an independent risk factor for failure (adjusted hazard ratio 2.13, P = 0.005). Treatment with vitrectomy-buckle compared favorably to vitrectomy alone (adjusted hazard ratio 0.58, P = 0.04). Only 8% of eyes that redetached achieved a best-corrected visual acuity of 20/200 or better, in comparison to 44% of eyes that did not redetach (P < 0.001). CONCLUSION:Proliferative vitreoretinopathy is a common complication after the repair of retinal detachment associated with open-globe trauma, and being a smoker is a risk factor for redetachment. Further study is needed to understand the pathophysiologic mechanisms underlying this correlation. 10.1097/IAE.0000000000001361
    FACTORS ASSOCIATED WITH SEROUS RETINAL DETACHMENT IN HIGHLY MYOPIC EYES WITH VERTICAL OVAL-SHAPED DOME. García-Ben Antonio,Sanchez María J Morillo,Gómez Ana Gonzalez,García-Basterra Ignacio,García Antonio Soler,García-Campos Jose M Retina (Philadelphia, Pa.) PURPOSE:This study investigated factors associated with persistent serous retinal detachment in highly myopic eyes with vertical oval-shaped domes. METHODS:Twenty-eight highly myopic patients (40 eyes) with smooth macular elevations related to a vertical oval-shaped dome were recruited. Serous retinal detachment was investigated; 11 eyes had persistent submacular fluid (study group) and 29 eyes lacked submacular fluid (control group). All patients underwent complete ophthalmologic examinations, including axial-length measurement and fluorescein angiography. Spectral domain optical coherence tomography scans through the fovea measured choroidal thicknesses, macular bulge height, and vitreoretinal interface factors. RESULTS:No studied variables (age, sex, spherical equivalence, axial length, vitreomacular traction, epiretinal membrane, and internal limiting membrane detachment) except higher macular bulge height (P = 0.03) and a reduced macular choroidal thickness (P = 0.02) were associated with the risk of serous retinal detachment. No statistically significant differences in best-corrected visual acuity were observed between the study and control groups. Serous retinal detachment always occurred at the top of the inward incurvation of the macula and was characterized by multiple hyperfluorescent granular patches on fluorescein angiography. CONCLUSION:A higher macular bulge height and a reduced macular choroidal thickness might be important factors in the development of serous retinal detachment in patients with vertical oval-shaped domes. 10.1097/IAE.0000000000001970
    Retinal Detachment Associated With Basketball-Related Eye Trauma. Lee Tsung-Han,Chen Yi-Hao,Kuo Hsi-Kung,Chen Yung-Jen,Chen Chih-Hsin,Lee Jong-Jer,Wu Pei-Chang American journal of ophthalmology PURPOSE:Basketball is a popular sport involving significant body contact, which may frequently result in ocular trauma. The aim of this study was to evaluate the characteristics and visual outcomes of retinal detachment associated with basketball-related injury. DESIGN:Retrospective, interventional case series. METHODS:We reviewed the course of patients who sustained traumatic retinal detachment from basketball-related ocular trauma between 2003 and 2015. RESULTS:Thirteen patients were evaluated for basketball-related traumatic retinal detachment. Twelve (92%) were male and 1 (8%) female, with an average age of 18.2 years. The majority (9 of 13, 70%) of patients had moderate-to-high myopia, and none were using protective eyewear when they sustained the eye trauma. Rhegmatogenous retinal detachment was observed in all eyes. The preoperative mean visual acuity was 20/625 (range, hand motions to 20/20). Initial surgery using scleral buckling alone was performed in most (8 of 13, 62%) of the patients. Retinal reattachment was achieved in 10 (76%) eyes after the first operation and in 12 (92%) at the end of the intervention. The mean follow-up was 3.9 years (range, 4 months to 12 years). The visual acuity during last follow-up was 20/231 (range, light perception to 20/20). In the multivariable analysis, initial visual acuity was an independent factor affecting the final visual outcome (P = .006). CONCLUSION:Retinal detachment associated with basketball-related injury may cause severe visual loss. In the current study, all retinal detachments were of rhegmatogenous type and commonly occurred in young individuals with myopia. Initial visual acuity was associated with the prognosis. Risk awareness for early detection and intervention are important in these traumas. 10.1016/j.ajo.2017.05.025
    Fundus autofluorescence and spectral domain optical coherence tomography as predictors for long-term functional outcome in rhegmatogenous retinal detachment. Poulsen Christina Doefler,Petersen M P,Green A,Peto T,Grauslund J Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie PURPOSE:To detect pre- and postoperative retinal changes in fundus autofluorescence (AF) and spectral domain optical coherence tomography (SD-OCT) and to correlate these with functional outcome in patients with primary rhegmatogenous retinal detachment (RRD). METHODS:A prospective, 30-month study of patients operated with 25-gauge vitrectomy for primary RRD. Patients were examined preoperatively and after 6 and 30 months, using ultrawide-field AF images (UWFI) (Optos 200Tx) and SD-OCT (Topcon 3D OCT-2000) imaging. RESULTS:Of 84 patients (84 eyes) included at baseline, 100.0 and 86.9% were re-examined at month 6 and 30, respectively. Preoperative findings such as macular attachment, detachment > 750 μm from foveola, lack of intraretinal separation, and subfoveal elevation ≤ 500 μm were all associated with better BCVA at months 6 and 30. Postoperative disruption of the photoreceptor layer was associated with poor BCVA at month 6 (p < 0.001) but not at month 30. At baseline, AF-demarcation of RRD was demonstrated by a hyperfluorescent edge in 92.0% and was associated with visual impairment at months 6 (p = 0.003) and 30 (p = 0.003). Visual outcome at month 30 was good (≤ 0.3 logMAR (≥ 20/40 Snellen)), regardless of the preoperative, macular status. However, with significantly better visual outcome in patients with macula attachments versus partly or totally macular detachments (p < 0.001). CONCLUSION:Fundus AF and SD-OCT is able to identify retinal reestablishment up to 30 months after primary RRD, with good correlation to BCVA. These findings emphasize the importance of long-term studies for final visual recovery. 10.1007/s00417-018-04222-w
    Vitreous Cytokine Expression and a Murine Model Suggest a Key Role of Microglia in the Inflammatory Response to Retinal Detachment. Kiang Lee,Ross Bing X,Yao Jingyu,Shanmugam Sumathi,Andrews Chris A,Hansen Sean,Besirli Cagri G,Zacks David N,Abcouwer Steven F Investigative ophthalmology & visual science Purpose:Retinal detachment (RD) separates the retina from the underlying retinal pigment epithelium, resulting in a gradual degeneration of photoreceptor (PR) cells. It is known that RD also results in an inflammatory response, but its contribution to PR degeneration is unknown. In this study we examine the inflammatory responses to RD in patient vitreous and validate a mouse experimental RD as a model of this phenomenon. Methods:Multiplex bead arrays were used to examine cytokine levels in vitreous samples from 24 patients with macula-off rhegmatogenous retinal detachment (RRD) undergoing reattachment surgery and from 10 control patients undergoing vitrectomy for vitreous opacities or epiretinal membrane. Activation of the innate immune response was then examined in a mouse model of RD. Results:Twenty-eight factors were significantly increased in vitreous from RD patients versus controls. Notable were the cytokines MCP-1 (CCL2), IP-10 (CXCL10), fractalkine (CX3CL1), GRO (CXCL1), MDC (CCL22), IL-6, and IL-8, which all exhibited relatively high concentrations and several-fold increases in the vitreous of RD patients. Concentrations of various analytes correlated with a range of clinical variables such as duration of detachment and visual acuity. Retinal detachment in the mouse resulted in cytokine mRNA expression changes consistent with human RD vitreous results, as well as microglial proliferation and migration toward the outer retina. Conclusions:The findings suggest that an inflammatory response involving microglia is a component of the reaction to retinal detachment that may impact visual acuity after surgical repair and that mouse experimental RD can serve as a model to study this effect. 10.1167/iovs.18-24489
    Position of macula lutea and presence of proliferative vitreoretinopathy affect vitreous cytokine expression in rhegmatogenous retinal detachment. Balogh Anikó,Milibák Tibor,Szabó Viktória,Nagy Zoltán Zsolt,Resch Miklós D PloS one Our purpose was to evaluate the concentrations of vitreous cytokines in patients with rhegmatogenous retinal detachment (RRD). We hypothesized that patients with macula on RRD have lower levels of cytokines compared to patients with macula off RRD and proliferative vitreoretinopathy (PVR). Vitreous fluids were collected during 23G pars plana vitrectomy from 58 eyes of 58 patients. Indication for vitrectomy included macula off and macula on RRD, PVR, and idiopathic epiretinal membrane (ERM). A multiplex chemiluminescent immunoassay was performed to measure the concentrations of 48 cytokines, chemokines, and growth factors. Levels of HGF, IL-6, IL-8, IL-16, IFN-gamma, MCP-1, and MIF were significantly higher in all groups of retinal detachment compared to ERM. Levels of CTACK, eotaxin, G-CSF, IP-10, MIG, SCF, SCGF-beta, SDF-1alpha were significantly higher in PVR compared to macula on RRD and ERM. Levels of IL-1ra, IL-5, IL-9, M-CSF, MIP-1alpha, and TRIAL were significantly higher in PVR compared to macula on RRD. Our results indicate that the position of macula lutea and the presence of PVR significantly influence vitreous cytokine expression. The detected proteins may serve as biomarkers to estimate the possibility of PVR formation and may help to invent personalized therapeutic strategies to slow down or prevent PVR. 10.1371/journal.pone.0234525
    Vitreous levels of apolipoprotein A1 and retinol binding protein 4 in human rhegmatogenous retinal detachment associated with choroidal detachment. Ding Nannan,Luo Shasha,Yu Jinjin,Zhou Ying,Wu Zhifeng Molecular vision Purpose:This study aims to quantify the concentration of apolipoprotein A1 (APOA1) and retinol binding protein (RBP4) expressed in the vitreous humors of patients with rhegmatogenous retinal detachment associated with choroidal detachment (RRDCD), rhegmatogenous retinal detachment (RRD), and idiopathic epimacular membrane (IEM). This study also aims to investigate the potential role of APOA1 and RBP4 as biomarkers of RRDCD. Methods:Enzyme-linked immunosorbent assay (ELISA) kits were used to obtain levels of APOA1 and RBP4 from the vitreous humor samples of 76 primary patients. These patients included 23 patients with RRDCD, 28 patients with RRD, and 24 patients with IEM. All patients were undergoing planned pars plana vitrectomy. The differences between the concentrations of the molecular biomarkers among different patient groups were analyzed using the Mann-Whitney U-test for nonparametric values and independent samples test or one-way ANOVA analysis for parametric data. The relationship between the molecular biomarkers, grades of proliferative vitreoretinopathy (PVR), and quadrants of retinal detachment were analyzed using nonparametric Spearman's rank correlation analysis. Results:The vitreous concentrations of APOA1 and RBP4 were statistically significantly higher in the RRDCD group compared to the RRD and IEM groups. Patients with severe PVR demonstrated a higher concentration of APOA1 and RBP4 compared to those with mild PVR, but this finding was not statistically significant. There was a statistically significant positive correlation between APOA1 and RBP4 in the RRDCD and RRD groups. Nonparametric Spearman's rank correlation analysis revealed that levels of APOA1 and RBP4 increased statistically significantly with an increasing number of detached retinal quadrants in the RRDCD and RRD groups. Conclusions:The findings of this study allude to the potential of APOA1 and RBP4 as specific biomarkers of RRDCD. The findings of this study may contribute to increased understanding regarding the role of APOA1 and RBP4 in RRDCD.